db‐McClure 2019.
Study characteristics | ||
Methods | Person‐time cohort (named "risk interval analysis") | |
Participants | Children were eligible if they had received their first dose of measles‐containing vaccine at age 12 through 23 months from January 2003 through September 2015. Children were excluded if they had a history of seizure or conditions strongly related to seizure prior to 12 months of age. Children born before 37 weeks gestational age were classified as preterm, and children born 37 weeks gestational age as full term. Preterm children were further classified into those born < 35 weeks (early preterm) and 35 through 36 weeks (late preterm) gestational age. The authors conducted a risk‐interval analysis amongst vaccinated children, with each child having 42 days of follow‐up following receipt of a measles‐containing vaccine. Days 7 through 10 following vaccination were defined as the risk interval, and days 15 through 42 following vaccination were defined as the control interval. Days 0 through 6 and 11 through 14 following vaccination were excluded. The first exclusion reduced possible short‐term effects with concomitant vaccines, and the latter exclusion was to avoid residual exposure effects in the control interval. |
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Interventions | MMRV vaccination | |
Outcomes | Seizures were identified by diagnostic codes in the inpatient or emergency department settings. | |
Funding Source | Government | |
Notes | Conclusion: vaccination with a measles‐containing vaccine in the second year of life is associated with a similar relative risk of a first seizure in children born preterm as in those who were born full term. | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
SCCS/PTC ‐ case selection | Low risk | Adequate ‐ independent validation |
SCCS/PTC ‐ exposure | Low risk | Adequate ‐ secure record |
SCCS/PTC ‐ observation and exposure risk period | Low risk | Adequate ‐ observation periods are well‐defined, exposure period appears to be well‐documented |
SCCS/PTC ‐ comparability | Low risk | Adjusted by age, gestational age |
Summary Risk of Bias assessment | Low risk | Plausible bias is unlikely to have seriously altered the results. |